Thursday, January 22, 2009

Why do people get nosebleeds

Why do people get nosebleeds?

The nose is a part of the body rich in blood vessels (vascular) and is situated in a vulnerable position as it protrudes on the face. As a result, trauma to the face can cause nasal injury and bleeding. The bleeding may be profuse, or simply a minor complication.

Nosebleeds can occur spontaneously when the nasal membranes dry out and crack. This is common in dry climates, or during the winter months when the air is dry and warm from household heaters. People are more susceptible to bleeding if they are taking medications which prevent normal blood clotting [warfarin (Coumadin), aspirin, or any anti-inflammatory medication]. In this situation, even a minor trauma could result in significant bleeding.

The incidence of nosebleeds is higher during the colder winter months when upper respiratory infections are more frequent, and the temperature and humidity fluctuate more dramatically. In addition, changes from a bitter cold outside environment to a warm, dry, heated home results in drying and changes in the nose which will make it more susceptible to bleeding. Nosebleeds also occur in hot dry climates with low humidity, or when there is a change in the seasons. The following factors predispose people to nosebleeds: 


Trauma, including self-induced by nose picking

Allergic and non-allergic rhinitis

Hypertension (high blood pressure)

Use of blood thinning medications

Alcohol abuse

Less common causes include tumors and inherited bleeding problems


Epistaxis (or a nosebleed in plain English) is the relatively common occurrence of hemorrhage from the nose, usually noticed when the blood drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, more likely to require medical attention). Sometimes in more severe cases, the blood can come up the nasolacrimal duct and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause nausea and vomiting. It accounts for only 0.001%[1] of all deaths in the U.S.Contents

The cause of nosebleeds

The cause of nosebleeds can generally be divided into two categories, local and systemic factors, although it should be remembered that a significant number of nosebleeds occur with no obvious cause.

Local factors
Anatomical deformities (eg. septal spurs or Osler-Weber-Rendu Syndrome)
Blunt trauma (usually a sharp blow to the face, sometimes accompanying a nasal fracture)
Foreign bodies (such as fingers during nose-picking)
Inflammatory reaction (eg. acute respiratory tract infections, chronic sinusitis, allergic rhinitis or environmental irritants)
Insufflated drugs (particularly cocaine)
Intranasal tumors (eg. Nasopharyngeal carcinoma or nasopharyngeal angiofibroma)
Low relative humidity of inhaled air (particularly during cold winter seasons)
Nasal prong O2 (tending to dry the olfactory mucosa)
Nasal sprays (particularly prolonged or improper use of nasal steroids)
Otic barotrauma (such as from descent in aircraft or ascent in scuba diving)
Surgery (eg. septoplasty and Functional Endoscopic Sinus Surgery)